Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era
Summary Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological mali...
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| Veröffentlicht in: | British journal of haematology 2019-11, Vol.187 (3), p.364-371 |
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| creator | Prusila, Roosa E. I. Sorigue, Marc Jauhiainen, Jyrki Mercadal, Santiago Postila, Aleksi Salmi, Petteri Tanhua, Taru Tikkanen, Susanna Kakko, Sakari Kuitunen, Hanne Pollari, Marjukka Nystrand, Ilja Kuusisto, Milla E. L. Vasala, Kaija Jantunen, Esa Korkeila, Eija Karihtala, Peeter Sancho, Juan‐Manuel Turpeenniemi‐Hujanen, Taina Kuittinen, Outi |
| description | Summary
Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow‐up time of 5·6 years. The 5‐year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5‐year risk of SHM was 0·5% after the first‐line treatment and 1·6% after the second‐line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first‐line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first‐line treatment, thereby postponing the added risk of SHM. |
| doi_str_mv | 10.1111/bjh.16090 |
| format | Article |
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Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow‐up time of 5·6 years. The 5‐year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5‐year risk of SHM was 0·5% after the first‐line treatment and 1·6% after the second‐line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first‐line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first‐line treatment, thereby postponing the added risk of SHM.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1111/bjh.16090</identifier><identifier>PMID: 31267514</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>follicular lymphoma ; Hematology ; Immunotherapy ; Incidence ; late effects of therapy ; Lymphoma ; Malignancy ; Monoclonal antibodies ; Remission ; Rituximab ; secondary haematological malignancies ; secondary leukaemia ; Targeted cancer therapy ; treatment related cancer</subject><ispartof>British journal of haematology, 2019-11, Vol.187 (3), p.364-371</ispartof><rights>2019 British Society for Haematology and John Wiley & Sons Ltd</rights><rights>2019 British Society for Haematology and John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3880-677546d514e393e6210793994a457d50e62ab7b7a5f0b80bea7d74f6731f28e53</citedby><cites>FETCH-LOGICAL-c3880-677546d514e393e6210793994a457d50e62ab7b7a5f0b80bea7d74f6731f28e53</cites><orcidid>0000-0002-8908-1542 ; 0000-0003-4741-7885</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjh.16090$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjh.16090$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31267514$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prusila, Roosa E. I.</creatorcontrib><creatorcontrib>Sorigue, Marc</creatorcontrib><creatorcontrib>Jauhiainen, Jyrki</creatorcontrib><creatorcontrib>Mercadal, Santiago</creatorcontrib><creatorcontrib>Postila, Aleksi</creatorcontrib><creatorcontrib>Salmi, Petteri</creatorcontrib><creatorcontrib>Tanhua, Taru</creatorcontrib><creatorcontrib>Tikkanen, Susanna</creatorcontrib><creatorcontrib>Kakko, Sakari</creatorcontrib><creatorcontrib>Kuitunen, Hanne</creatorcontrib><creatorcontrib>Pollari, Marjukka</creatorcontrib><creatorcontrib>Nystrand, Ilja</creatorcontrib><creatorcontrib>Kuusisto, Milla E. L.</creatorcontrib><creatorcontrib>Vasala, Kaija</creatorcontrib><creatorcontrib>Jantunen, Esa</creatorcontrib><creatorcontrib>Korkeila, Eija</creatorcontrib><creatorcontrib>Karihtala, Peeter</creatorcontrib><creatorcontrib>Sancho, Juan‐Manuel</creatorcontrib><creatorcontrib>Turpeenniemi‐Hujanen, Taina</creatorcontrib><creatorcontrib>Kuittinen, Outi</creatorcontrib><title>Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era</title><title>British journal of haematology</title><addtitle>Br J Haematol</addtitle><description>Summary
Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow‐up time of 5·6 years. The 5‐year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5‐year risk of SHM was 0·5% after the first‐line treatment and 1·6% after the second‐line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first‐line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first‐line treatment, thereby postponing the added risk of SHM.</description><subject>follicular lymphoma</subject><subject>Hematology</subject><subject>Immunotherapy</subject><subject>Incidence</subject><subject>late effects of therapy</subject><subject>Lymphoma</subject><subject>Malignancy</subject><subject>Monoclonal antibodies</subject><subject>Remission</subject><subject>Rituximab</subject><subject>secondary haematological malignancies</subject><subject>secondary leukaemia</subject><subject>Targeted cancer therapy</subject><subject>treatment related cancer</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kVFr1TAUx4M43HX64BeQgC_60C1pkib1bQ51GwNB9LmctqdrrmlzTVJmP4TfebneqSAYDgQOv_ODP39CXnB2yvM7a7fjKa9YzR6RDReVKkou-WOyYYzpgjNpjsnTGLeMccEUf0KOBS8rrbjckJ-fbfxG_UAjdn7uIax0BJwgeedvbQeOTuDs7QxzZzFSO9MdJItzivTOppEO3jnbLQ4Cdeu0G_0EbynMecCt0ca9mrPS_D1LASFhv1elEWmwaflhJ2gpBnhGjgZwEZ8__Cfk64f3Xy4ui5tPH68uzm-KThjDikprJas-B0BRC6xKznQt6lqCVLpXLG-g1a0GNbDWsBZB91oOlRZ8KA0qcUJeH7y74L8vGFMz2dihczCjX2JTlopXpjZSZvTVP-jWLyGny5RgtTJcCZOpNweqCz7GgEOzCzlUWBvOmn1HTe6o-dVRZl8-GJd2wv4P-buUDJwdgDvrcP2_qXl3fXlQ3gPMHpry</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Prusila, Roosa E. I.</creator><creator>Sorigue, Marc</creator><creator>Jauhiainen, Jyrki</creator><creator>Mercadal, Santiago</creator><creator>Postila, Aleksi</creator><creator>Salmi, Petteri</creator><creator>Tanhua, Taru</creator><creator>Tikkanen, Susanna</creator><creator>Kakko, Sakari</creator><creator>Kuitunen, Hanne</creator><creator>Pollari, Marjukka</creator><creator>Nystrand, Ilja</creator><creator>Kuusisto, Milla E. L.</creator><creator>Vasala, Kaija</creator><creator>Jantunen, Esa</creator><creator>Korkeila, Eija</creator><creator>Karihtala, Peeter</creator><creator>Sancho, Juan‐Manuel</creator><creator>Turpeenniemi‐Hujanen, Taina</creator><creator>Kuittinen, Outi</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8908-1542</orcidid><orcidid>https://orcid.org/0000-0003-4741-7885</orcidid></search><sort><creationdate>201911</creationdate><title>Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era</title><author>Prusila, Roosa E. I. ; Sorigue, Marc ; Jauhiainen, Jyrki ; Mercadal, Santiago ; Postila, Aleksi ; Salmi, Petteri ; Tanhua, Taru ; Tikkanen, Susanna ; Kakko, Sakari ; Kuitunen, Hanne ; Pollari, Marjukka ; Nystrand, Ilja ; Kuusisto, Milla E. 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L.</creatorcontrib><creatorcontrib>Vasala, Kaija</creatorcontrib><creatorcontrib>Jantunen, Esa</creatorcontrib><creatorcontrib>Korkeila, Eija</creatorcontrib><creatorcontrib>Karihtala, Peeter</creatorcontrib><creatorcontrib>Sancho, Juan‐Manuel</creatorcontrib><creatorcontrib>Turpeenniemi‐Hujanen, Taina</creatorcontrib><creatorcontrib>Kuittinen, Outi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prusila, Roosa E. I.</au><au>Sorigue, Marc</au><au>Jauhiainen, Jyrki</au><au>Mercadal, Santiago</au><au>Postila, Aleksi</au><au>Salmi, Petteri</au><au>Tanhua, Taru</au><au>Tikkanen, Susanna</au><au>Kakko, Sakari</au><au>Kuitunen, Hanne</au><au>Pollari, Marjukka</au><au>Nystrand, Ilja</au><au>Kuusisto, Milla E. L.</au><au>Vasala, Kaija</au><au>Jantunen, Esa</au><au>Korkeila, Eija</au><au>Karihtala, Peeter</au><au>Sancho, Juan‐Manuel</au><au>Turpeenniemi‐Hujanen, Taina</au><au>Kuittinen, Outi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2019-11</date><risdate>2019</risdate><volume>187</volume><issue>3</issue><spage>364</spage><epage>371</epage><pages>364-371</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><abstract>Summary
Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow‐up time of 5·6 years. The 5‐year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5‐year risk of SHM was 0·5% after the first‐line treatment and 1·6% after the second‐line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first‐line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first‐line treatment, thereby postponing the added risk of SHM.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>31267514</pmid><doi>10.1111/bjh.16090</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8908-1542</orcidid><orcidid>https://orcid.org/0000-0003-4741-7885</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | follicular lymphoma Hematology Immunotherapy Incidence late effects of therapy Lymphoma Malignancy Monoclonal antibodies Remission Rituximab secondary haematological malignancies secondary leukaemia Targeted cancer therapy treatment related cancer |
| title | Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era |
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